Provider Demographics
NPI:1548424427
Name:LIN, JAMES C (DMD)
Entity Type:Individual
Prefix:DR
First Name:JAMES
Middle Name:C
Last Name:LIN
Suffix:
Gender:M
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3450 LACEY ROAD
Mailing Address - Street 2:
Mailing Address - City:DOWNERS GROVE
Mailing Address - State:IL
Mailing Address - Zip Code:60560
Mailing Address - Country:US
Mailing Address - Phone:630-882-8844
Mailing Address - Fax:630-882-8535
Practice Address - Street 1:320 E VETERANS PKWY
Practice Address - Street 2:
Practice Address - City:YORKVILLE
Practice Address - State:IL
Practice Address - Zip Code:60560-1767
Practice Address - Country:US
Practice Address - Phone:630-882-8844
Practice Address - Fax:630-882-8535
Is Sole Proprietor?:No
Enumeration Date:2008-07-10
Last Update Date:2016-08-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL019024562122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist